Rehabilitation Of Edentulous Patients Research Articles

Rehabilitation of Edentulous Patient with Customized Functional Palatal Contours

Abstract To restore the stomatognathic system of the patient with an edentulous span of 12–13 years who presents flabby tissue in the maxillary tuberosity region, severe resorption in the mandible along with reduced masticatory efficiency, and speech impairments in his old dentures. Complete denture rehabilitation helps patients cope with the significant psychological and social consequences of tooth loss. In today’s image-conscious culture, dentures help sufferers reconnect with the world and re-establishes normal form, function, and esthetics. The most common complaints about prostheses are chewing, as well as poor esthetics and phonetics. Prosthetic rehabilitation for denture wearers should include more than just replacing missing teeth. The ultimate goals should be phonetics, esthetics, and oral function restoration. This article describes a simple, low-cost, practical, and beneficial procedure for the rehabilitation of people with complete dentures who have speech impairment, bone resorption, and flabby tissue. A 71-year-old male patient who is a teacher by profession and has a 30-year habit of chewing kharra paid a visit to the Department of Prosthetic Dentistry at Sharad Pawar Dental College and Hospital in Sawangi, Wardha. He was dissatisfied with his previous dentures because they did not provide adequate chewing quality, pronunciation, or esthetics. After compiling his dental history, it was discovered that he had previously worn dentures for 12 years and had missing teeth due to periodontal disease for 12–13 years. The case report affirms a simple and unique technique for the fabrication of dental prostheses. Palatograms are common, but the technique described in the case report is simple to implement. We achieved both form and function by resolving the issues of residual ridge resorption in the mandibular arch and flabby tissue in the maxillary arch. To summarize, deviations from natural speech immediately following complete denture rehabilitation are completely normal, and a pretreatment speech diagnosis is required for a more accurate comparison. Accustoming the patient to such instantaneous speech deviations must improve his adaptability. Palatograms are useful in identifying these deviations and confirming corrected palatal contours. Simple and low-cost, it is ideal for patients with total dentures and speech disorders.

Intraorally welded wing abutments supporting full-arch prostheses: A retrospective clinical study.

Delayed loading in the rehabilitation of edentulous patients with an implant-supported prosthesis implies a longer treatment time. It requires additional surgery to uncover the submerged implants, and this may increase patients' discomfort and morbidity. The immediate loading-based technique described in this article involves creating a metal framework by intraorally welding the implants pair by pair, using specific wing abutments. The aim of the study was to investigate the implant-prosthetic success and complication rates of this technique when used to rehabilitate totally edentulous patients. The clinical records of totally edentulous patients were retrospectively evaluated. The prosthetic success rate as well as technical and biological complications were analyzed. Furthermore, the implant survival and success rates were assessed by measuring marginal bone loss (MBL) at the implant, prosthesis and patient levels. The records of 37 patients (284 implants and 43 prostheses) were included in the study. At the last follow-up (45.5 ±33.6 months), the prosthetic success rate was 100%. Mucositis affected 4 implants (1.4%), while peri-implantitis affected 4 implants (1.4%). Meanwhile, 7 implants (2.5%) showed a lack of early osseointegration. According to the criteria of Albrektsson et al., 271 implants (95.4%) were successful. The average MBL at the implant, prosthesis and patient levels was 0.26 ±0.42 mm, 0.26 ±0.19 mm and 0.26 ±0.18 mm, respectively. The technique described in this article seems to be a viable approach to the rehabilitation of totally edentulous patients through immediate loading. However, these results should be confirmed by appropriately designed prospective and comparative clinical studies.

Rehabilitation of full-arch edentulism with fixed or removable dentures retained by root-form dental implants: A systematic review of outcomes and outcome measures used in clinical research in the last 10 years.

To evaluate outcome measures, methods of assessment, and analysis in clinical studies on the rehabilitation of full-arch edentulism with implant-supported fixed or removable prostheses. A protocol-oriented search was conducted in MEDLINE via PubMed, EMBASE, and Cochrane Library (PROSPERO registration CRD42021265179) from 1 January 2011 to 27 July 2021 to identify longitudinal studies reporting on the rehabilitation of edentulous patients with implant-supported prostheses. The primary aim of this study was the collection of all objectively reported outcomes in each study. Secondary aims included the description of the methods of assessment and analytical methods. Risk of bias was applied according to the study design (randomized controlled trial, cohort study, or descriptive pre-post study). Individual study data were extracted into an outcomes matrix. Outcomes were grouped into domains and descriptively analysed. A network diagram was generated to establish relationships between domains. The present review follows the PRISMA statement. The screening and selection processes resulted in the identification of 491 publications, corresponding to 421 different studies (cohorts of patients). Only 24% of the studies reported the use of EQUATOR network guidelines. Implant failure/survival was the most reported outcome (270 studies), but the criterion to determine implant failure and/or survival was frequently not described or was ambiguous. Implant success was much less frequently reported (88) and was based on several heterogenous composite definitions. Marginal bone levels (233 studies), technical complications (158), and clinical outcomes (150), including peri-implant soft tissue and implant stability assessment, were also frequently reported. Patient-reported outcome measures (PROMs) (145) and function-based outcomes (40) were predominantly reported in isolation from other outcomes and most frequently in removable restorations. While quality of life was evaluated using valid instruments, patient satisfaction was evaluated based on a common sense concept of satisfaction. Economic outcomes were under-reported (13). There is great heterogeneity in the criteria to define implant failure or survival and implant success, which prevents the comparison of rates across studies. Even though studies frequently report multiple outcomes, PROMs are usually reported in isolation from other outcomes. It would be valuable to have a set of core outcome variables and standardized methods of measurement for future studies.

Rehabilitation of full-arch edentulism with fixed or removable dentures retained by root-form dental implants: A systematic review of outcomes and outcome measures used in clinical research in the last 10 years.

To evaluate outcome measures, methods of assessment, and analysis in clinical studies on the rehabilitation of full-arch edentulism with implant-supported fixed or removable prostheses. A protocol-oriented search was conducted in MEDLINE via PubMed, EMBASE, and Cochrane Library (PROSPERO registration CRD42021265179) from 1 January 2011 to 27 July 2021 to identify longitudinal studies reporting on the rehabilitation of edentulous patients with implant-supported prostheses. The primary aim of this study was the collection of all objectively reported outcomes in each study. Secondary aims included the description of the methods of assessment and analytical methods. Risk of bias was applied according to the study design (randomized controlled trial, cohort study, or descriptive pre-post study). Individual study data were extracted into an outcomes matrix. Outcomes were grouped into domains and descriptively analysed. A network diagram was generated to establish relationships between domains. The present review follows the PRISMA statement. The screening and selection processes resulted in the identification of 491 publications, corresponding to 421 different studies (cohorts of patients). Only 24% of the studies reported the use of EQUATOR network guidelines. Implant failure/survival was the most reported outcome (270 studies), but the criterion to determine implant failure and/or survival was frequently not described or was ambiguous. Implant success was much less frequently reported (88) and was based on several heterogenous composite definitions. Marginal bone levels (233 studies), technical complications (158), and clinical outcomes (150), including peri-implant soft tissue and implant stability assessment, were also frequently reported. Patient-reported outcome measures (PROMs) (145) and function-based outcomes (40) were predominantly reported in isolation from other outcomes and most frequently in removable restorations. While quality of life was evaluated using valid instruments, patient satisfaction was evaluated based on a common sense concept of satisfaction. Economic outcomes were under-reported (13). There is great heterogeneity in the criteria to define implant failure or survival and implant success, which prevents the comparison of rates across studies. Even though studies frequently report multiple outcomes, PROMs are usually reported in isolation from other outcomes. It would be valuable to have a set of core outcome variables and standardized methods of measurement for future studies.

Single implant overdenture – a more sustainable treatment option for resorbed mandible

Rehabilitation of edentulous patient is done by dentist with the fabrication of complete denture. It is commonly observed that mandibular dentures are not satisfactory when compared to maxillary denture due to centrifugal resorption of mandible. Thus rehabilitation of atrophied edentulous mandible by using implant to support and retain the prosthesis is an acceptable treatment option. It adds to the denture stability, increase masticatory efficiency and comfort of the patient. The present case report discuss about a patient with prosthodontics rehabilitation consisting of single implant supported overdenture.

Estabelecendo a oclusão lingualizada na reabilitação de pacientes edêntulos com próteses totais removíveis

This article describes the protocol with specific techniques for the establishment of a lingualized occlusion in the rehabilitation of edentulous patients with removable complete dentures.

A questionnaire study on the impact on oral health-related quality of life by conventional rehabilitation of edentulous patient

PurposeThis study aimed to determine whether complete dentures improve the oral health-related quality of life (OHRQoL) of edentulous patients, and to assess any associations related to age, gender, and OHRQoL.Material and methodsHundred edentulous patients who required conventional complete denture treatment were selected for this study. The following inclusion criteria were established: edentulous in both jaws with no previous history of denture treatment and no significant medical history. The patients were selected who satisfied the criteria associated with the class I prosthodoctic diagnostic index. OHRQoL of the patients were assessed twice, once pre treatment (at the first visit) and once post treatment (8 weeks post insertion of dentures) using an instrument called OHIP-EDENT-N. Significant differences in the OHIP-EDENT-N scores between pre treatment and post treatment were calculated using the Wilcoxon Signed-Rank test. Gender differences were assessed using the Mann–Whitney test.ResultsAfter provision of new complete dentures, all domains of the OHIP-EDENT-N showed significant improvements except physical pain and social disability.ConclusionsThe results of this study indicated that conventional complete denture improved the OHRQoL of edentulous patients.

Evaluation of nasopalatine canal using cone beam computed tomography - A retrospective study

Background: Implantology is a very significant branch of dentistry that deals with the rehabilitation of edentulous patients. Thus, knowledge of anatomical variations of related neurovascular structures such as the nasopalatine canal is essential. Aim:The aim of study was to determine the form, length, and diameter of the nasopalatine canal using CBCT. Materials and Methods: In this retrospective study, images were archived from CBCT unit and visualized using Romexis software. The nasopalatine canals of 50 patients between the age range of 18-59years were analyzed. The shape of the nasopalatine canal, length of the nasopalatine canal and the diameter of incisive foramen were assessed in sagittal and coronal section. The width of labial and palatal alveolar bone around the canal and inclination of the nasopalatine canal to hard palate were evaluated. Statistics: (1) if there is any relation between the gender and the assessed parameters (2) if there is any relation between edentulous and partially edentulous patients with the assessed parameters. Results: The most common shape of the nasopalatine canal was cylindrical. The average length of the nasopalatine canal was 12.14±2.41 mm and the average diameter of incisive foramen 3.45±0.84 mm anteroposteriorly and 3.77±0.94mm mediolaterally. The average inclination of the nasopalatine canal to hard palate was 119.93±9.73° Conclusion: This study highlights the variations seen in the nasopalatine canal. The close vicinity of nasopalatine canal and implant can lead to sensory disturbances and damage of the tissues. Thus, a thorough knowledge before the surgical - implant procedure using cone beam computed tomography seems beneficial.

Interalveolar ridge crest relation analysis and rehabilitation of edentulous patient using dental CAD software: A case report

Interalveolar ridge crest relation analysis and rehabilitation of edentulous patient using dental CAD software: A case report

Dental Implant Rehabilitation in Patients Suffering from Mucocutaneous Diseases: A Systematic Review and Meta-Analysis

Objective: Dental implantations are widely used for oral rehabilitation of edentulous patients. Despite high success rate, there are some risk factors that have been associated with failures. Oral mucocutaneous diseases are one of these risk factors for implant insertion due to the immunosuppressive therapy. There are limited studies that have dealt with the subject of dental implantology in oral mucosal disorders mainly with patients with oral lichenplanus, pemphigoid, pemphigus vulgaris, and systemic lupus erythematosus. In order to assess the result of implantations in such patients, we have reviewed the studies. Materials and Methods: We searched PubMed, Science Direct, and Cochrane databases for articles published from Jan 2000 to Dec 2017, using key search word “dental implants”, “oral lichen planus”, “pemphigoid”, “pemphigus vulgaris” and ”systemic lupus erythematosus”. Results: The random effects analysis result shows overall failure rates of 22% in patients with oral lichen planus. A systematic review revealed some failures that are not definitely related to these diseases. Conclusion: Due to the lack of adequate studies, a meta-analysis was only possible for oral lichen planus. Presently, there is no definite guideline regarding the placement of implant in patients suffering from mucocutaneous diseases; nevertheless, we should always consider that these patients are specific cases and need more attention in the first step of treatment and follow-ups. So there is a need to further clinical studies in order to evaluate more risk factors accurately and make a definitive conclusion.

Osseointegration of standard and mini dental implants: a histomorphometric comparison

BackgroundMini dental implants (MDIs) are becoming increasingly popular for rehabilitation of edentulous patients because of their several advantages. However, there is a lack of evidence on the osseointegration potential of the MDIs. The objective of the study was to histomorphometrically evaluate and compare bone apposition on the surface of MDIs and standard implants in a rabbit model.MethodsNine New Zealand white rabbits were used for the study to meet statistical criteria for adequate power. Total 18 3M™ESPE™ MDIs and 18 standard implants (Ankylos® Friadent, Dentsply) were inserted randomly into the tibia of rabbits (four implants per rabbit); animals were sacrificed after a 6-week healing period. The specimens were retrieved en bloc and preserved in 10% formaldehyde solution. Specimens were prepared for embedding in a light cure acrylic resin (Technovit 9100). The most central sagittal histological sections (30–40 μm thick) were obtained using a Leica SP 1600 saw microtome. After staining, the Leica DM2000 microscope was used, the images were captured using Olympus DP72 camera and associated software. Bone implant contact (BIC) was measured using Infinity Analyze software.ResultsAll implants were osseointegrated. Histologic measures show mineralized bone matrix in intimate contact with the implant surface in both groups. The median BIC was 58.5 % (IQR 8.0) in the MDI group and 57.0 % (IQR 5.5) in the control group (P > 0.05; Mann-Whitney test). There were no statistical differences in osseointegration at 6 weeks between MDIs and standard implants in rabbit tibias.ConclusionsBased on these results, it is concluded that osseointegration of MDIs is similar to that of standard implants.

Zygomatic Implant-Supported Prosthesis: When the Prosthetic Rehabilitation Affects the Function: A Case Report

The oral rehabilitation of edentulous patients can be done in different ways depending on the alveolar ridge morphology and patient expectations. The objective of this clinical case was to report prosthetic and functional adaptation difficulties when conventional complete denture was changed to a zygomatic implant-supported prosthesis. We report a 52-year-old male singer with an atrophic maxilla who was rehabilitated with zygomatic implant-supported prosthesis using 4 implants. However, the thickness of the prosthesis in the palatal region and the space between the prosthesis and soft tissue caused difficulty in speaking and singing. The palatal region of the prosthesis was trimmed and the anterior region of the prosthesis was relined. These procedures were performed to make room for the tongue and minimize the passage of air during speech. Adaptations in the shape of the prosthesis must be made to enable its use, without compromising its strength.

İmplant Destekli Sabit Metal-Seramik-Kompozit Hibrid Protez Yapımı

Rehabilitation of edentulous patients with excessivelly resorbed alveolar ridges with implant retained fixed partial dentures is clinically a challenging situation. Vertical and horizontal bone resorbtion creates malalligned jaw relations which mandates vertical and horizontal block bone grafting for proper soft tissue support and occlussion. Grafting implant site have some disadvantages in term of patient discomfort, treatment time, treatment cost and above all high risk of graft failure. The following case report presents an alternative method for the treatment of excesivelly resorbed maxilla with implant retained metalceramic composite dentures without any bone grafting procedure.

Magnetic Resonance Imaging in Complete Denture Treated Edentulous Patients with Obstructive Sleep Apnea Syndrome-A Preliminary Study

Background: Complex clinical presentation of obstructive sleep apnea syndrome (OSAS) is increasingly present in modern dentistry. In this research, we have been assumed that the reconstruction of optimal vertical dimension of occlusion (VDO) with complete dentures could reduce symptoms of mild to moderate sleep apnea in edentulous patients who have not worn dentures or have used inadequate ones. The aim of this study was to determine how the prosthetic treatment of edentulous patients with OSAS can extend the upper airways, reduce the accompanying day and night symptoms of sleep apnea and reduce the value of apnea-hypopnea index (AHI/h). Methods: The study comprised 9 edentulous patients with OSAS (AHI/h 5.70 to 26.30). The complete dentures with optimal VDO reconstruction were made for all patients. For the purposes of this study, the following were used: Epworth sleepiness scale (ESS) polysomnographic registration (PSG) of AHI/h, the diagnosis of the diameter of the upper respiratory tract by magnetic resonance imaging (MRI) before and 3 months after the prosthetic rehabilitation. Results: Prosthetic treatment of edentulous patients reduces day and night time symptoms of OSAS. Sagittal and axial tomograms of the pharynx in edentulous patients with OSAS before and 3 months after the treatment indicate significant differences in the diameter of the upper airways, which are correlated with reduced AHI/h (49.93%). Conclusion: The complete dentures prosthetic rehabilitation of edentulous patients, with optimal VDO reconstruction, increases the diameter of the upper respiratory tract which is reflected in a significant reduction of OSAS symptoms and AHI/h.

Rehabilitation of edentulous patient suffering from severe gag reflex with palate-free denture and intramucosal zirconia inserts

A hypersensitive gagging reflex often prevents the dentist from carrying out critical procedures or causes them to perform less satisfactorily. Complete dentures fabricated for patients suffering from hypersensitive gag reflex generally have compromised retention and stability. The use of intramucosal inserts to aid retention of a maxillary denture has been reported in the past. Zirconia is a tissue compatible biomaterial whose scope and application in dentistry is on the rise. This paper reports the fabrication of zirconia intramucosal inserts and the technique of its incorporation in the maxillary complete denture to enhance retention, stability and thereby oral function in gag reflex patients.

Retraction: Prosthetic rehabilitation of edentulous patient with limited oral access: A clinical report

Retraction: Prosthetic rehabilitation of edentulous patient with limited oral access: A clinical report

Clinical aspects in the treatment planning for rehabilitation with overdenture and protocol-type prosthesis

Objective: The aim of this study was to criticaly review the published literature regarding the clinical aspects involved in the rehabilitation of edentulous patients using Branemark protocol and overdenture prostheses. Methods: An active search was conducted in the LILACS, MEDLINE, PubMed, and SciELO databases using the descriptors: "Coating for dentures" (Overlay Prosthesis and Overdenture) and "Implant-supported fixed dental prosthesis" (Protesis dental de suporte implantado, Dental prosthesis, and Implant Supported Prosthesis) in Portuguese, English, and Spanish between January 2000 and October 2014. Results: The following parameters should be considered when selecting between Branemark protocol and overdenture prostheses: bone support, lip support, lip-line, upper lip length, oral mucosa conditions and size, alveolar ridge contour, crown-bone ratio, interarch space, and speaking space. Overdenture rehabilitation can provide many benefits to patients, such as prosthetic retention, stability, comfort, and improved aesthetics. Conclusions: This study highlights the need for a thorough individualized treatment planning to ensure that fixed prostheses and overdentures have an excellent prognosis when used appropriately in suitable patients at the appropriate time.

Customizing guidance flange prosthesis for management of segmental mandibulectomy

Treatment of benign and malignant tumors may involve surgical resection of the mandible, which may be segmental or hemisectioned. The prosthetic rehabilitation of resected mandible becomes difficult when preprosthetic planning is not considered. Preprosthetic plastic surgery and/or implant assisted overdenture may enhance the prosthetic rehabilitation of edentulous patients who have undergone resection of the mandible. Due to medical conditions, unwillingness for additional surgery or economical restraints, the treatment is limited to guidance flange prosthesis. The guidance flange prosthesis helps in directing the deviating mandible to improve form and function. This case report describes a procedure for fabricating customized guiding flange prosthesis to rehabilitate edentulous segmental mandibulectomy.

FEM and VonMises analyses of different dental implant shapes for masticatory loading distribution

The rehabilitation of edentulous patients is today a challenge for the clinicians. The healthy of the hard and soft issue may be considered a fundamental element for having long-term results. The dental implant progresses about the predictable and safe results made this technique chosen from a large group of practitioners. However some problems related intra-operative and postoperative conditions may create discomfort on the patients and consequently to the clinician. The unfavourable results are often related to the bone tissue quality but sometime the dental implant shape and the prosthesis framework may undergo to technical difficulties. The purpose of this work is, through the use of appropriate FEM models, to analyse the effect of all these parameters in the construction of a prosthesis type "Toronto", evaluating all the surgical and prosthetic components in order to direct the choices made by the surgeon and to optimize the distribution of loads reducing the patient's discomfort and having a long term clinical success.

Full mouth rehabilitation of a patient with mandibular implant screw retained Fp-3 prosthesis opposing maxillary acrylic removable over-denture

A hybrid denture is one that is fabricated over a metal framework and retained by screws threaded into the implant abutments. The anterior part of a mandibular hybrid denture is fixed on implants while the posterior part of the denture is extended and cantilevered from implants. This article presents the fabrication of a maxillary over-denture opposing mandibular implant retained hybrid prosthesis. A total of four implants were placed in the mandibular arch. Castable abutments were used to produce the optimal angulations. Framework was waxed, cast recovered, and the fit was refined until the framework seated passively on the master cast. The mandibular denture teeth were waxed to the hybrid framework, and a final wax try-in was performed to verify and correct maxillomandibular relations before processing. The prosthesis was inserted after verification of occlusion, retention, and stability. The rehabilitation of edentulous patients with hybrid dentures has been observed to achieve greater masticatory function and psychological satisfaction than with conventional over-dentures. Producing a passive-fitting substructure for a fixed removable screw retained hybrid prosthesis is arguably one of the most technically complex tasks in implant dentistry. The technique presented may not initially produce a perfectly passive framework, but use of disclosing media and adjusting the internal aspect of the casting can result in non-binding, fully seated prostheses.